For patients suffering from severe forms of the movement disorder “dystonia,” there’s some good news on the horizon: a recent study has just confirmed the benefits of an existing form of treatment called “deep brain stimulation” (DBS). I know; it doesn’t sound too appealing, but let’s review the basics so you have a better idea of what the experts are talking about.
Affecting more than 300,000 people in North America, dystonia is a neurological disorder that impairs a person’s movement; specifically, it causes uncontrollable muscle contractions in any part of the body, including the face, eyelids, vocal chords, arms, legs, and torso. These contractions can be painful, especially when they contort the body into unusual and uncomfortable positions; the movements can be jerky or sustained for a long period of time, and are often repetitive.
Obviously, dystonia can make everyday activities difficult, even impairing sight and hearing at times. In severe cases, some sufferers are confined to bed. Conversely, one of the mildest forms of dystonia is writer’s cramp. The causes of dystonia are various, including a genetic abnormality, injury during birth, toxins, injury, stroke, or other health conditions (e.g. Wilson’s disease).
DBS or “bilateral pallidal neurostimulation” is a procedure that is already in use. A tiny wire, which is placed surgically in the brain, delivers mild shocks that interfere with the signals that cause the involuntary muscle movements. The wire is connected to a small battery- powered generator that is placed under the skin, near the collarbone of the patient. Using a special magnet, the patient can turn it on or off.
Although DBS has been recognized as a successful treatment for two other movement disorders — Parkinson’s disease and tremors — as well as depression, it has not, until now, received much recognition for its potential in treating severe dystonia.
The latest study involved 40 patients with dystonia that was either affecting their entire body or one or two specific body parts. Each individual underwent surgery in order to implant the DBS device. After the operation, the study subjects were split into two groups: one receiving actual DBS and the other receiving fake stimulation. The two groups underwent therapy for three months and were monitored for improvement.
At the end of three months, the movement disorder patients receiving DBS had significant changes in their condition — let’s break it down into three categories: 1) condition severity was reduced by 39%, 2) disability decreased by 38%, and 3) physical factors pertaining to quality of life were improved by 30%.
However, that wasn’t the end of it. The study continued on for three more months, during which time both groups of patients received the actual DBS treatment. At the end of the six-month study, there was a 46% improvement in movement amongst all dystonia sufferers. Moreover, half of the 40 participants saw a 51% decrease in their symptoms. Overall, the emotional state of the dystonia patients was noted to have improved after the treatment.
It seems that DBS could have benefits on a dystonia sufferer’s physical performance as well as his/her mood and mental health. This makes sense when you consider the severe limitations uncontrolled movement and frequent pain can put on a person’s life.
Note that there were some surgery-related complications in 18% of study participants (e.g. infection); but this possibility is to be expected with any surgical procedure.